What are some important features of achalasia?

Answer 1

Typical Clinical vignette:

40 y/o man presents with increasing difficulty swallowing both liquids and solids, complaining of undigested food regurgitation. Patient endorses heartburn, chest pain and weight loss.

Unknown etiology

Common testing circumstances:

Characteristic elevated lower esophageal sphincter pressure, "bird beak" on barium shallow and ineffective anti-acids including proton pump inhibitors.

You will often see this question asked with an x-ray of a barium shallow showing "bird Beak" or a graph with the pressure values shown as you progress down the anatomy (Oral cavity, pharynx, upper esophagus, lower esophagus, and stomach). Expect to see the pressure rise in the lower esophagus region to be very high, this is a strong indicator for achalasia.

Answer 2

Impaired esophageal peristalsis

Elevated lower esophageal sphincter (LES) pressure

Failure of the LES to relax